脑电图反应性分级对急性一氧化碳中毒迟发性脑病早期诊断及预后的评估价值  

The value on the evaluation of classification of EEG reactivity for diagnosis of early stage and prognostic of delayed encephalopathy caused by acute carbon monoxide poisoning

作　　者：逯霞[1] 艾克拜尔.哈里克 张晶晶[1] 闫宝锋 许健[1] 木塔力甫.努热合买提 许菊芳[1] 栾新平[1] LU Xia;Aikebaier Ha-like;ZHANG Jing-jing(Cerebral Palsy Center, The Second Affiliated Hospital of Xinjiang Medical University,Urumqi 830011,China)

机构地区：[1]新疆医科大学第二附属医院脑瘫中心,新疆乌鲁木齐830011

出　　处：《中国医学装备》2017年第8期84-87,共4页China Medical Equipment

基　　金：新疆自治区自然科学基金(青年基金)(2013211B52)"脑瘫鼠颈动脉外膜剥脱手术前后脑电图;脑干听觉诱发电位;TCD监测指标的对比研究"

摘　　要：目的:评估脑电图反应性分级(ECBER)在急性一氧化碳(CO)中毒后迟发性脑病(DEACMP)早期诊断及预后结局的临床价值。方法:选择74例临床诊断为急性CO中毒昏迷的患者,依据是否发生DEACMP将其分为发生DEACMP的观察组(31例)和未发生DEACMP的对照组(43例)。比较两组患者年龄、既往病史、中毒后昏迷时间、脑电图(EEG)评分及ECBER分级等临床指标差异。以临床诊断为金标准,评估ECBER分级对DEACMP的早期诊断敏感性、特异性及准确性。应用多因素Logistic回归分析与发病3个月患者生存率相关的危险因素。结果:观察组与对照组相比,其既往病史评分、中毒后昏迷时间、EEG评分及ECBER分级等临床指标差异均有统计学意义(t=2.361,t=2.822,t=3.398,t=3.279;P<0.05)。ECBER早期诊断DEACMP的灵敏度、特异度和准确率分别为83.9%、76.7%和79.7%。多因素Logistic回归分析显示,ECBER分级是发病3个月DEACM患者生存率的危险因素(OR=3.624,P<0.05)。结论:ECBER能够早期诊断DEACMP,并且能较好地评估急性CO中毒昏迷的患者短期预后结果。Objective:To evaluate the clinical value of EEG classification based on EEG reactivity(ECBER)on the early diagnosis and prognostic outcome for delayed encephalopathy caused by acute carbon monoxide poisoning.Methods:74insensible patients with acute carbon monoxide poisoning(ACMP)who were confirmed by clinical diagnosis were divided into observation group(31cases,once happen delayed encephalopathy after acute carbon monoxide poisoning,DEACMP)and control group(43cases,non-DEACMP).The differences of a series of indexes including age,anamnesis,coma time post-ACMP,EEG score and classification of ECBER between the two groups were compared.The clinical diagnosis was used as the golden standard to evaluate sensitivity,specificity and accuracy of classification of ECBER for early diagnosis of DEACMP.The multivariate Logistic regression analysis was used to analyze which risk factor was relevant with survival rate of patients who has been DEACMP for3months.Results:The differences of a series of clinical indexes including score for anamnesis,coma time post-ACMP,score of EEG and classification of ECBER between observation group and control group were statistical significant(t=2.361,t=2.822,t=3.398,t=3.279,P<0.05).The sensitivity,specificity and accuracy of early diagnosis of ECBER for DEACMP were83.9%,76.7%,and79.7%,respectively.The results of multivariate Logistic regression analysis indicated that classification of ECBER was the risk factor of survival rate of patients with DEACMP for3months.Conclusion:The ECBER can efficiently diagnose the DEACMP in early stage,and it can better evaluate prognostic outcome of short period for patients with DEACMP.

关 键 词：EEG分级标准 脑电图反应性 急性一氧化碳中毒 迟发性脑病 预测价值 

分 类 号：R595.1[医药卫生—内科学]